If you’re an International Medical Graduate getting ready for your first NHS job, chances are you’ve come across two words that can sound confusingly similar: shadowing and observership. On the surface, they may feel like the same thing, both involve you being in a hospital without actually working as a doctor. But the truth is, there are big differences between the two, and knowing which one will actually help you more could make a huge difference in how confident you feel on your first day in the NHS.
A lot of IMGs ask, “Which one should I try to get?” or “Will shadowing count more on my CV than an observership?” If you’re wondering the same thing, this blog is here to break it all down in simple, honest terms.
What Shadowing Really Means for IMGs
Shadowing is exactly what it sounds like, you follow a doctor in the NHS around like their shadow. It’s not about sitting in a lecture or just standing quietly in the corner. It’s about being in the ward, watching how a doctor actually works, listening to the way they take handovers, and seeing how they speak to nurses, patients, and relatives.
The big thing about shadowing is that it’s usually linked directly to your first NHS job. For example, once you get hired as a Junior Clinical Fellow or FY2, many trusts will give you a formal shadowing period before your official start date. This time is your chance to learn the system without the pressure of being the one responsible for patient care. You don’t carry a bleep, you don’t prescribe, you don’t make decisions, but you’re close enough to see what those decisions look like in real life.
Shadowing is like the NHS telling you, “Welcome. Here’s a sneak peek before we expect you to fly solo.”
What an Observership Involves
Observership, on the other hand, is a more general opportunity for you to watch NHS doctors at work, but it’s not formally tied to a job you’ve already secured. Think of it as dipping your toes into the NHS world before you officially enter it.
You might arrange an observership by contacting a consultant or department and asking if you can spend a few weeks watching their clinical practice. During an observership, you’re not part of the rota, you don’t have responsibilities, and you may not even be included in patient handovers or team discussions. In many cases, you’ll simply be there to watch and learn.
For IMGs who are still trying to get their first job, an observership can be a lifesaver. It gives you UK hospital exposure, it lets you understand the workflow, and it can sometimes lead to networking opportunities that open doors later.
Which One Prepares You Better?
Now comes the important question: which one actually prepares you more for your first NHS job?
If you already have a job offer, shadowing is hands down the most useful. You’ll be walking the same wards where you’ll soon be working, getting to know the electronic systems, and learning exactly how your future team communicates. It takes away that feeling of being thrown into the deep end.
But if you haven’t landed a job yet, observership is often the only real option available. While it might not feel as hands-on or structured as shadowing, it still gives you something powerful: context. You’ll understand the flow of a ward round, the way British doctors phrase things, and the kind of teamwork the NHS expects. For many IMGs, even a short observership can remove the fear of the unknown and boost your confidence during interviews.
How Each One Looks on Your CV
Another thing many IMGs worry about is how shadowing vs. observership will look on a CV or portfolio. Here’s the truth: employers don’t expect you to have shadowed before every job, but they do value evidence of NHS exposure.
Shadowing before your official start doesn’t usually get added as “experience,” since it’s part of the induction. However, it definitely helps when your consultant sees you handling things more smoothly in your first weeks.
Observership, though, can be listed under “UK Clinical Experience” on your CV, and it can sometimes make the difference in showing recruiters that you’ve taken initiative to learn how the NHS works.
The Human Side of Both
One thing you might not find in official definitions is the emotional side of shadowing and observership. Both give you something every IMG desperately needs: reassurance. When you shadow, you see that other doctors also ask questions, make mistakes, and rely on teamwork. When you observe, you realise that even in a new country with a different system, medicine still feels familiar at its core.
This reassurance is priceless. It’s what helps you step into your NHS role with less fear and more confidence.
So, Which Should You Aim For?
Here’s the simple answer: if you have a job lined up, shadowing is the most direct way to prepare. If you’re still looking for a job, observership is your stepping stone. And if you can manage both at different points of your journey, you’ll be even better prepared.
What matters more than the label is the mindset you bring. Whether you’re shadowing or observing, treat it like your rehearsal for the real performance. Ask yourself: How do doctors manage their time? How do they talk to nurses? What do they write in notes? Every little detail you notice can save you from stress later.
Final Thoughts
As an IMG, there’s no single right way to prepare for your NHS career. Shadowing gives you practical confidence before your start date. Observership helps you understand the NHS culture even before you’ve landed your first role. Both matter, and both can help you walk into your first day with a sense of “I’ve seen this before, I can do it.”
And when you’re trying to figure out your readiness for your first NHS job or your next step in the UK, don’t just rely on luck, assess yourself properly.
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